- Equipment
- Commercial pressure monitoring device (e.g. Stryker Intracompartmental Pressure Monitor)
- Alternatively: arterial line manometer + needle setup
- Sterile gloves, antiseptic, local anaesthetic, 18G needle or side-port catheter
- Preparation
- Identify compartments at risk
- Mark the site over the muscle belly, avoiding bony prominences
- Clean with antiseptic and use local anaesthetic if patient is conscious
- Technique
- Attach the pressure monitor to the needle and prime the system with saline
- Insert needle perpendicular to skin into the compartment (e.g. 2–3 cm deep into anterior leg)
- Ensure tip lies within muscle belly and not subcutaneous tissue or bone
- Inject a small amount of saline (if required by device) to transmit pressure
- Wait for the reading to stabilise
- Record the pressure, typically in mmHg
- Normal vs abnormal
- Normal: < 10 mmHg
- Borderline: 20–30 mmHg
- Compartment syndrome likely if:
- Absolute pressure > 30 mmHg
- Or delta pressure (diastolic BP − compartment pressure) < 30 mmHg
- https://www.youtube.com/watch?v=kFIyFTKim3U&ab_channel=MedStarEmergencyPhysicians